Adriana Matos and Dr. William Olsen, Anthropology
Among the Asante people of central Ghana, health and healing are conceptualized quite differently than the western biomedical model. Religious cosmology has special significance in relation to healing. Health is thought of holistically; every illness is a product of physical, spiritual, emotional, and cosmological forces. Illnesses manifest themselves in the body, but unlike the biomedical view of health, it is not the bodily affliction that is the root of the problem. In order to cure a disease, the true cause must be discovered and resolved. Although many of the traditional beliefs have been pushed out or reduced by the growing use of biomedicine, western pharmaceuticals, as well as by outside religions such as Christianity and Islam, many of the traditional ideas of medicine and health still operate in society.
In Ghana I spent much of my time interviewing local mothers who had lost children in order to discover what they understood about their infant’s deaths. I also interviewed many different traditional herbalists, diviner, and midwives to learn how they understood and treated infant disease and explained infant death. Additionally, I spent time in the district hospital observing modern medical practice. I found that even though biomedicine is widely seen as effective, the patients themselves have very little understanding of their disease and the reasons for their symptoms. Many instances of infant morbidity and mortality are still explained in terms of the traditional spiritual and cosmological forces.
One of my most significant findings was that people often explain child illness by putting child disease that is not responding well to biomedical treatment under the category called asram. Asram is explained as a traditional disease that affects only young infants. It is considered spiritual in nature, meaning it is caused by jealousy, witchcraft, or other spiritual forces rather than by physical agents. Spiritual diseases such as asram are not considered curable by western medication and require traditional herbal remedies to both prevent and heal them. The specifics of asram are extremely detailed, including several different forms of the disease each with their own set of herbal treatments, which I studied in depth. Belief in asram is also extremely common: several informants estimated the disease to affect about half of all children. In fact, asram beliefs are so central to their understanding of infant health that prevention and treatment of the disease are integrated into their everyday child care practices.
In terms of infant mortality, the descriptions and explanations of disease are much more complex. In many West African societies, beliefs in reincarnation of children, specifically the rebirth and death of the same child multiple times to the same mother, are used to explain the recurrent loss of children to one mother. In my own research I found that this idea was moderately familiar to traditional healers and diviners, but was not really used as means of explaining high death rates. Even so, the way that children are buried and the way that their illnesses are treated seem to point to a special status for infants as vulnerable spiritual beings with a much higher risk of death. In death, infants are treated quite differently than adults, and the expectations of maternal grief are quite harsh in many cases. In fact, the patterns of maternal grief proved to be the most telling as to how infant death is conceptualized in this culture.
When an adult person dies among the Asante, the funeral ceremony is extremely large and expensive. The body is preserved for weeks or even months and then a large celebration lasting for several days takes place. When a child dies, however, they are buried the same day in an unmarked grave by the father or other male kin. The mother of the child is absolutely not allowed to follow the body to the grave. Instead, a ritual is performed for her where she is given food to eat by her family and neighbors and encouraged to get on with her life with the insistence that she will have more children. After this ritual is performed, the mother is not supposed to cry, at least publicly, over the death of her baby. Excess grief is considered extremely unhealthy and is almost universally described as causing the mother to become barren. Because childbearing is highly valued in Asante society and is required for proper respect and social status, women are made to focus on children they currently have and to try and have more children rather than prolonging grief for the many that are lost.
Since infant mortality is a huge problem in the region, the people have found a way to explain and cope with infant death. Traditional cosmological beliefs that are evidenced in practices like asram care and funeral rites seem to point to the vulnerability of children to death. This is part of the reason why infant mortality is treated so differently than adult death, and why people are encouraged to move quickly on with their lives. In order to better address the problem of infant mortality, I believe that it is important to understand what the practices and beliefs are and how the deaths of the children really affect the lives of the mothers. That way, solutions can be culturally appropriate and much more effective in addressing the problems and needs of the community.